340B Drug Pricing Program Database
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DSH440104EA Erlanger Health (Active)
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Main Details
Name
Erlanger Health
Subdivision Name
CH Lactation Clinic
Type
Disproportionate Share Hospital
Rural
No
340B ID
DSH440104EA
Medicare Provider Number
440104
Outpatient Facility Provider Number
Additional Details
Current Program Status
Active
Registration Date
10/5/2016
Participating Start Date
1/1/2017
Participating Approval Date
11/17/2016
Last Recertification Date
9/8/2024
Contacts
Authorizing Official
Erlanger Health
Misty Brackett, VP Revenue Cycle
(423) 778-9775
Primary Contact
Erlanger Health System
Ngoc T. Le, 340B Program Coordinator
(423) 778-8194
Addresses
Street Address
910 Blackford Street
Ground Floor Massoud Building
Chattanooga, TN 37403
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Parent/Child
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